The cost of laparoscopic versus open cholecystectomy in a community hospital.
Case-Control Studies; Cholecystectomy; Cholecystectomy/*economics; Community; Fees; Female; Health; Hospital Charges/statistics & numerical data; Hospital Costs/statistics & numerical data; Hospitals; Humans; Insurance; Laparoscopic/*economics; Male; Medicaid/economics; Medical/statistics & numerical data; Medicare/economics; Middle Aged; Ohio; Reimbursement/statistics & numerical data; Retrospective Studies; United States
This retrospective study reviewed the hospital and professional costs, charges, and reimbursements for laparoscopic cholecystectomy (lap chole) and open cholecystectomy (open chole) and compared the two procedures. There was no significant difference in hospital costs between lap and open chole procedures; however, there were marked differences in the categories of costs for each procedure. The mean total (hospital and professional) charge was 8% greater for lap chole. The mean total (hospital and professional) reimbursement for patients with private insurance was 23% greater for lap chole, but no significant difference was seen for patients on Medicare or Medicaid. Lap chole patients returned to work 11 days sooner than open chole patients; this can result in a 69% decrease in short-term disability costs to employers. The clinical variables that significantly affect total charges and reimbursement are discussed.
Vanek V W; Bourguet C C
Surgical endoscopy
1995
1995-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/bf00187776" target="_blank" rel="noreferrer noopener">10.1007/bf00187776</a>
Patient Insurance Profiles: A Tertiary Care Compared to Three Freestanding Emergency Departments.
Emergency Service; Emergency Service – Statistics and Numerical Data; freestanding emergency department; Health – Statistics and Numerical Data; Health – Trends; Health/*statistics & numerical data/trends; Hospital/*statistics & numerical data; Hospitals; Human; Humans; insurance; Insurance; Medicaid – Statistics and Numerical Data; Medicaid/statistics & numerical data; Medically Uninsured – Statistics and Numerical Data; Medically Uninsured/statistics & numerical data; Medicare – Statistics and Numerical Data; Medicare/statistics & numerical data; Retrospective Design; Retrospective Studies; Special – Statistics and Numerical Data; Tertiary Care Centers/statistics & numerical data; United States; Urban – Statistics and Numerical Data; Urban/*statistics & numerical data
BACKGROUND: It has been speculated that freestanding emergency departments (FEDs) draw more affluent, better-insured patients away from urban hospital EDs. It is believed that this leaves urban hospital-based EDs less financially secure. OBJECTIVE: We examined whether the distribution of patients with four types of insurance (self-pay, Medicaid, Medicare, and private) at the main ED changed after opening three affiliated FEDs, and whether the insurance type distribution was different between main ED and FEDs and between individual FEDs. METHODS: A retrospective analysis of insurance status of all patients presenting to our EDs from July 2006 through August 2013. Insurance was divided into self-pay, Medicare, Medicaid, and private insurance across three time periods, which reflect the sequential opening of each FED. Insurance types for each facility were compared for individual time periods and across time periods. chi(2) was used to analyze the data. RESULTS: In the three studied time frames (periods B, C, and D), there were less privately insured patients and more self-pay, Medicaid, and Medicare patients at the main than at each FED (p \textless 0.001). Insurance types were significantly different between each of the three FEDs and the main ED (p \textless 0.001) and between each of the three FEDs (p \textless 0.001). CONCLUSIONS: There were less privately insured patients and more self-pay, Medicaid, and Medicare patients at the main ED compared to the FEDs. Privately insured patients decreased at both the FEDs and main ED during the study. Insurance distribution was significantly different between the main ED, and three FEDs, and between individual FEDs.
Simon Erin L; Griffin Gregory; Orlik Kseniya; Jia Zhenyu; Hayslip Dave; Kobe Daniel; Jouriles Nicholas
The Journal of emergency medicine
2016
2016-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jemermed.2016.05.058" target="_blank" rel="noreferrer noopener">10.1016/j.jemermed.2016.05.058</a>
Supervision Requirements: Criteria for the Nurse and Auxiliary Staff When Providing Patient Care Visits.
*Wound Healing; Ambulatory Care/*methods/standards; Clinical Supervision; Guideline Adherence/standards; Health; House Calls; Humans; Incident Reports; Insurance; Nurse-Physician Relations; Ostomy and Continence Nursing; Patient Care Planning/*standards; Physician's Role; Quality of Nursing Care – Evaluation; Reimbursement; Supervisors and Supervision; United States; Workforce; Wound
Physician or advanced care clinicians' (advanced practice nurses, physician assistants) orders are routinely carried out by nursing staff, with the goals of implementing treatment plans and improving patient outcomes. In the outpatient setting, nurses must consider the regulations imposed by the Centers for Medicare & Medicaid Services when initiating care and billing for services. Nurses, advanced practice nurses, and other clinicians may deliver care ordered by physicians without the physician being physically present in the room. Such services are considered to be "incident to" the physician's care, and there are requirements of supervision that must be met pertaining to the specific care setting. These guidelines and the implications for WOC nurses are the focus of this article.
Vargo Deanna; Vargo Paige
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society
2016
2016-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/WON.0000000000000209" target="_blank" rel="noreferrer noopener">10.1097/WON.0000000000000209</a>
Student identification of ethical issues in a primary care setting.
*Education; *Ethics; *Primary Health Care; Confidentiality; Decision Making; Graduate; Health; Humans; Insurance; Medical; Medical/psychology; Morals; Ohio; Perception; Physician Impairment; Physician-Patient Relations; Students; Thinking
Ethical issues in the clinical arena have received significant attention during the past few decades. Limited focus has been directed toward ethical issues in the primary care office setting. A study was conducted to determine the ethical perspectives through critical review discussions between medical students and their preceptors during the PCP programme. Major ethical themes and percent of occurrence emerging from an analysis of the summaries of their discussions included decision-making (40%), professional standards (16%), locus of care (12%), community responsibility (10%), and confidentiality (10%). This study adds to the evidence that while the ethical issues prevalent in the primary care setting are less dramatic than those in a hospital, they are sufficiently frequent to warrant inclusion in the curriculum, enabling students to become more sensitive to their existence.
Homenko D F; Kohn M; Rickel T; Wilkinson M L
Medical education
1997
1997-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/j.1365-2923.1997.tb00041.x" target="_blank" rel="noreferrer noopener">10.1111/j.1365-2923.1997.tb00041.x</a>
Digital Breast Tomosynthesis: Cost-Effectiveness of Using Private and Medicare Insurance in Community-Based Health Care Facilities.
Female; Humans; Retrospective Studies; United States; breast cancer; Breast Neoplasms/*diagnostic imaging; *Cost-Benefit Analysis; Biopsy/methods; cost-effectiveness; digital breast tomosynthesis; Mammography/*economics; Medicare/*economics; screening mammography; Insurance; Health/*economics
OBJECTIVE: The purpose of this study was to determine whether digital breast tomosynthesis (DBT) is a cost-effective alternative to full-field digital mammography (FFDM) for both Medicare and privately insured patients undergoing screening mammography. MATERIALS AND METHODS: A retrospective data analysis was performed between July 15, 2013, and July 14, 2014, with data on women presenting for screening mammography that included any additional radiologic workup (n = 6319). Patients chose to undergo DBT or FFDM on the basis of personal preference, physician suggestion, and cost difference. The summation of findings over the
Hunter Sara A; Morris Colleen; Nelson Karl; Snyder Brandon J; Poulton Thomas B
AJR. American journal of roentgenology
2017
2017-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2214/AJR.16.16987" target="_blank" rel="noreferrer noopener">10.2214/AJR.16.16987</a>
Going bare leaves you too exposed. Skipping malpractice insurance attractive but risky for physicians tired of paying premiums.
Humans; United States; Malpractice/*economics/legislation & jurisprudence; Physicians/*economics/legislation & jurisprudence; Insurance; Liability/*economics
Weinstock Frank J
Medical economics
2009
2009-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Socioeconomics of ophthalmic surgical care in the new millennium.
Medically Uninsured; Health; Insurance; Reimbursement; Medicare; Eye Surgery – Economics
Health care in the future will continue to be complex and involve private companies and the government. Decisions regarding medical necessity will need to be made regarding the type and intensity of care for different individuals. Insurance programs will limit care by denial of nonessential procedures, but they will make care available to the workforce and the uninsured. Demographics of patients, providers, and facilities will limit care for some individuals. Technology will continue to evolve rapidly, causing some current procedures to become unnecessary, and will allow for more efficient and cost-efficient care and cures that are unknown today. Copyright © 2000 by W.B. Saunders Company
Weinstock F J; Meltzer G
Ophthalmology Clinics of North America
2000
2000-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s0896-1549(05)70164-4" target="_blank" rel="noreferrer noopener">10.1016/s0896-1549(05)70164-4</a>
Insurance Status And The Variable Management Of Children Presenting To The Emergency Department With Bronchiolitis
asthma; bronchiolitis; care; coverage; Emergency Medicine; health-insurance; hospitalizations; infants; insurance; Pediatrics; respiratory syncytial virus; serious bacterial-infection; socioeconomic-status; united-states; us children
Damore D; Mansbach J M; Clark S; Ramundo M; Camargo C A
Pediatric Emergency Care
2010
2010-10
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1097/PEC.0b013e3181f39861" target="_blank" rel="noreferrer noopener">10.1097/PEC.0b013e3181f39861</a>
Health>Education>Health
Education; Medicine; Insurance; Social Work; Health policy; Medicine & Public Health; Health Psychology; Medical Sociology; Premedical Education; Race and ethnicity
I first met Carmendita as she was graduating from high school and needed her physical to go to college. Carmen, a bright, African American female, was so excited to be going to Muskingum University. The first person in her family to go to college, she had a full academic scholarship and planned to become a veterinarian. She had younger siblings and wanted to show them that with hard work, they could go on to higher education, too. As a first-generation college attender and oldest of four myself, I spoke with her about the challenges and future rewards. Carmen grew up in the inner city of a declining rust belt city and was interested in helping her family financially as well. She looked forward to being able to help younger siblings and her mother when she was able to become a vet.
Janice M Spalding
Health Disparities : Weaving A New Understanding Through Case Narratives
2019
1905-7
Journal Article
<a href="http://doi.org/10.1007/978-3-030-12771-8_41" target="_blank" rel="noreferrer noopener">10.1007/978-3-030-12771-8_41</a>